Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Chiropractic & Manual Therapies
Published in: Chiropractic & Manual Therapies 1/2016

Open Access 01-12-2016 | Research

Sick leave and healthcare utilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum

Authors: Cecilia Bergström, Margareta Persson, Ingrid Mogren

Published in: Chiropractic & Manual Therapies | Issue 1/2016

Login to get access

Abstract

Background

Pregnancy related low back pain (PLBP) and pelvic girdle pain (PGP) are considered common complications of pregnancy. The long-term consequences for women with persistent PLBP/PGP postpartum are under-investigated. The main objective was to investigate the prevalence, pattern and degree of sick leave as well as healthcare utilisation and its perceived effect in women with persistent PLBP/PGP at 12 months postpartum.

Method

This is a follow-up study of a cohort involving of a sample of women, who delivered from January 1st 2002 to April 30th in 2002 at Umeå University Hospital and Sunderby Hospital, and who reported PLBP/PGP during pregnancy. A total of 639 women were followed-up by a second questionnaire (Q2) at approximately 6 months postpartum. Women with persistent PLBP/PGP at the second questionnaire (N = 200) were sent a third questionnaire (Q3) at approximately 12 months postpartum.

Results

The final study sample consisted of 176 women reporting PLBP/PGP postpartum where N = 34 (19.3 %) reported ‘no’ pain, N = 115 (65.3 %) ‘recurrent’ pain, and N = 27 (15.3 %) ‘continuous’ pain. The vast majority (92.4 %) of women reported that they had neither been on sick leave nor sought any healthcare services (64.1 %) during the past 6 months at Q3. Women with ‘continuous’ pain at Q3 reported a higher extent of sick leave and healthcare seeking behaviour compared to women with ‘recurrent’ pain at Q3. Most women with persistent PLBP/PGP had been on sick leave on a full-time basis. The most commonly sought healthcare was physiotherapy, followed by consultation with a medical doctor, acupuncture and chiropractic.

Conclusion

Most women did not report any sick leave or sought any healthcare due to PLBP/PGP the past 6 months at Q3. However, women with ‘continuous’ PLBP/PGP 14 months postpartum did report a higher prevalence and degree of sick leave and sought healthcare to a higher extent compared to women with ‘recurrent’ PLBP/PGP at Q3. Women with more pronounced symptoms might constitute a specific subgroup of patients with a less favourable long-term outcome, thus PLBP/PGP needs to be addressed early in pregnancy to reduce both individual suffering and the risk of transition into chronicity.
Literature
1.
Bergstrom C, Persson M, Mogren I. Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy - pain status, self-rated health and family situation. BMC Pregnancy Childbirth. 2014;14:48.PubMedCentralCrossRefPubMed
2.
Gutke A, Ostgaard HC, Oberg B. Predicting persistent pregnancy-related low back pain. Spine (Phila Pa 1976). 2008;33:E386–93.CrossRef
3.
Noren L, Ostgaard S, Johansson G, Ostgaard HC. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J. 2002;11:267–71.PubMedCentralCrossRefPubMed
4.
Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17:794–819.PubMedCentralCrossRefPubMed
5.
6.
Wu WH, Meijer OG, Uegaki K, Mens JM, van Dieen JH, Wuisman PI, et al. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. Eur Spine J. 2004;13:575–89.PubMedCentralCrossRefPubMed
7.
Gutke A, Josefsson A, Oberg B. Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms. Spine (Phila Pa 1976). 2007;32:1430–6.CrossRef
8.
Albert HB, Godskesen M, Korsholm L, Westergaard JG. Risk factors in developing pregnancy-related pelvic girdle pain. Acta Obstet Gynecol Scand. 2006;85:539–44.CrossRefPubMed
9.
Juhl M, Andersen PK, Olsen J, Andersen AM. Psychosocial and physical work environment, and risk of pelvic pain in pregnancy. A study within the Danish national birth cohort. J Epidemiol Community Health. 2005;59:580–5.PubMedCentralCrossRefPubMed
10.
Mogren I. Perceived health, sick leave, psychosocial situation, and sexual life in women with low-back pain and pelvic pain during pregnancy. Acta Obstet Gynecol Scand. 2006;85:647–56.CrossRefPubMed
11.
Mogren IM. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J. 2006;15:1093–102.PubMedCentralCrossRefPubMed
12.
13.
Robinson HS, Mengshoel AM, Bjelland EK, Vollestad NK. Pelvic girdle pain, clinical tests and disability in late pregnancy. Man Ther. 2010;15:280–5.CrossRefPubMed
14.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96.CrossRefPubMed
15.
SBU. Metoder för behandling av långvarig smärta. En systematisk litteraturöversikt. Stockholm: Statens beredning för medicinsk utvärdering (SBU); 2006. SBU-rapport nr 177/1. ISBN 91-85413-08-9.
16.
Eriksen J, Sjogren P, Ekholm O, Rasmussen NK. Health care utilisation among individuals reporting long-term pain: an epidemiological study based on Danish National Health Surveys. Eur J Pain (Lond Engl). 2004;8:517–23.CrossRef
17.
Hojsted J, Alban A, Hagild K, Eriksen J. Utilisation of health care system by chronic pain patients who applied for disability pensions. Pain. 1999;82:275–82.CrossRefPubMed
18.
Hartvigsen J, Davidsen M, Sogaard K, Roos EM, Hestbaek L. Self-reported musculoskeletal pain predicts long-term increase in general health care use: a population-based cohort study with 20-year follow-up. Scand J Public Health. 2014;42:698–704.CrossRefPubMed
19.
Albert H, Godskesen M, Westergaard J. Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand. 2001;80:505–10.CrossRefPubMed
20.
Sadr S, Pourkiani-Allah-Abad N, Stuber KJ. The treatment experience of patients with low back pain during pregnancy and their chiropractors: a qualitative study. Chiropr Man Therap. 2012;20:32.PubMedCentralCrossRefPubMed
21.
Ostgaard HC, Zetherstrom G, Roos-Hansson E. Back pain in relation to pregnancy: a 6-year follow-up. Spine (Phila Pa 1976). 1997;22:2945–50.CrossRef
22.
Stuge B, Veierod MB, Laerum E, Vollestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a two-year follow-up of a randomized clinical trial. Spine (Phila Pa 1976). 2004;29:E197–203.CrossRef
23.
Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine (Phila Pa 1976). 2005;30:983–91.CrossRef
24.
Hartvigsen J, Nielsen J, Kyvik KO, Fejer R, Vach W, Iachine I, et al. Heritability of spinal pain and consequences of spinal pain: A comprehensive genetic epidemiologic analysis using a population-based sample of 15,328 twins ages 20–71 years. Arthritis Rheum. 2009;61:1343–51.CrossRefPubMed
25.
Linton SJ, Boersma K. Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro Musculoskeletal Pain Questionnaire. Clin J Pain. 2003;19:80–6.CrossRefPubMed
26.
Leboeuf-Yde C, Gronstvedt A, Borge JA, Lothe J, Magnesen E, Nilsson O, et al. The nordic back pain subpopulation program: demographic and clinical predictors for outcome in patients receiving chiropractic treatment for persistent low back pain. J Manipulative Physiol Ther. 2004;27:493–502.CrossRefPubMed
27.
Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J. 2003;12:149–65.PubMedCentralPubMed
28.
Costa Lda C, Maher CG, McAuley JH, Hancock MJ, Herbert RD, Refshauge KM, et al. Prognosis for patients with chronic low back pain: inception cohort study. BMJ. 2009;339:b3829.CrossRefPubMed
29.
Thomas E, Silman AJ, Croft PR, Papageorgiou AC, Jayson MI, Macfarlane GJ. Predicting who develops chronic low back pain in primary care: a prospective study. BMJ. 1999;318:1662–7.PubMedCentralCrossRefPubMed
30.
George C. The six-month incidence of clinically significant low back pain in the Saskatchewan adult population. Spine (Phila Pa 1976). 2002;27:1778–82.CrossRef
31.
Larsen EC, Wilken-Jensen C, Hansen A, Jensen DV, Johansen S, Minck H, et al. Symptom-giving pelvic girdle relaxation in pregnancy. I: Prevalence and risk factors. Acta Obstet Gynecol Scand. 1999;78:105–10.CrossRefPubMed
32.
Ostgaard HC, Andersson GB. Previous back pain and risk of developing back pain in a future pregnancy. Spine (Phila Pa 1976). 1991;16:432–6.CrossRef
33.
Ostgaard HC, Andersson GB, Karlsson K. Prevalence of back pain in pregnancy. Spine (Phila Pa 1976). 1991;16:549–52.CrossRef
34.
35.
Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27:E109–20.CrossRefPubMed
36.
Bjelland EK, Stuge B, Engdahl B, Eberhard-Gran M. The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study. BJOG. 2013;120:32–40.CrossRefPubMed
37.
Olsson CB, Nilsson-Wikmar L, Grooten WJ. Determinants for lumbopelvic pain 6 months postpartum. Disabil Rehabil. 2012;34:416–22.CrossRefPubMed
38.
Ferreira ML, Machado G, Latimer J, Maher C, Ferreira PH, Smeets RJ. Factors defining care-seeking in low back pain--a meta-analysis of population based surveys. Eur J Pain (Lond Engl). 2010;14:747. e1-7.
39.
Close C, Sinclair M, Liddle SD, Madden E, McCullough JE, Hughes C. A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy. J Adv Nurs. 2014;70:1702–16.CrossRefPubMed
40.
Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;9:CD001139.PubMed
41.
Stuber KJ, Smith DL. Chiropractic treatment of pregnancy-related low back pain: a systematic review of the evidence. J Manipulative Physiol Ther. 2008;31:447–54.CrossRefPubMed
42.
Wuytack F, Curtis E, Begley C. The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: A descriptive qualitative study. Midwifery. 2015;31:1104–9.CrossRefPubMed
43.
Wuytack F, Curtis E, Begley C. Experiences of First-Time Mothers With Persistent Pelvic Girdle Pain After Childbirth: Descriptive Qualitative Study. Phys Ther. 2015;95:1354–64.CrossRefPubMed
44.
Cote P, Cassidy JD, Carroll L. The treatment of neck and low back pain: who seeks care? who goes where? Med Care. 2001;39:956–67.CrossRefPubMed
45.
Stuge B, Hilde G, Vollestad N. Physical therapy for pregnancy-related low back and pelvic pain: a systematic review. Acta Obstet Gynecol Scand. 2003;82:983–90.CrossRefPubMed
46.
Ferreira CW, Alburquerque-Sendi NF. Effectiveness of physical therapy for pregnancy-related low back and/or pelvic pain after delivery: a systematic review. Physiother Theory Pract. 2013;29:419–31.CrossRefPubMed
47.
48.
Machado GC, Maher CG, Ferreira PH, Pinheiro MB, Lin CW, Day RO, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ. 2015;350:h1225.PubMedCentralCrossRefPubMed
49.
Williams CM, Maher CG, Latimer J, McLachlan AJ, Hancock MJ, Day RO, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014;384:1586–96.CrossRefPubMed
50.
Elden H, Ladfors L, Olsen MF, Ostgaard HC, Hagberg H. Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. BMJ. 2005;330:761.PubMedCentralCrossRefPubMed
51.
Peterson CD, Haas M, Gregory WT. A pilot randomized controlled trial comparing the efficacy of exercise, spinal manipulation, and neuro emotional technique for the treatment of pregnancy-related low back pain. Chiropr Man Therap. 2012;20:18.PubMedCentralCrossRefPubMed
52.
Leboeuf-Yde C, Nielsen J, Kyvik KO, Fejer R, Hartvigsen J. Pain in the lumbar, thoracic or cervical regions: do age and gender matter? A population-based study of 34,902 Danish twins 20–71 years of age. BMC Musculoskelet Disord. 2009;10:39.PubMedCentralCrossRefPubMed
53.
Gausel AM, Kjaermann I, Malmqvist S, Dalen I, Larsen JP, Okland I. Pelvic girdle pain 3–6 months after delivery in an unselected cohort of Norwegian women. Eur Spine J. 2015.
54.
Voss M, Stark S, Alfredsson L, Vingard E, Josephson M. Comparisons of self-reported and register data on sickness absence among public employees in Sweden. Occup Environ Med. 2008;65:61–7.CrossRefPubMed
55.
Metadata
Title
Sick leave and healthcare utilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum
Authors
Cecilia Bergström
Margareta Persson
Ingrid Mogren
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2016
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/s12998-016-0088-9

Other articles of this Issue 1/2016

Chiropractic & Manual Therapies 1/2016 Go to the issue

Case report

Spinal myxopapillary ependymoma in an adult male presenting with recurrent acute low back pain: a case report

Research

Match injuries in amateur Rugby Union: a prospective cohort study - FICS Biennial Symposium Second Prize Research Award

Study protocol

Dose–response of spinal manipulation for cervicogenic headache: study protocol for a randomized controlled trial

Research

Perception of peer physical examination in two Australian osteopathy programs

Research

Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial

Systematic review

Similarities and differences of graduate entry-level competencies of chiropractic councils on education: a systematic review